Carbon dioxide (CO₂) laser ablation treatment of a peri-urethral genital wart: A case report

Visible genital warts are caused by the nearly 100 recognized strains of human papillomavirus (HPV). HPV infections caused by high-risk strains are associated with significant morbidity and mortality rates. Genital warts are diagnosed by visual inspection and treated by three major methods: topical agents, systemic agents, and surgical therapies. CO₂ laser ablation is the best treatment option for warts that present as refractory, thick, extensive lesions. CO₂ ablation offers benefits such as a painless procedure, increased clearance rate, lesser side-effects and decreased pain.

An 18-year old patient was referred to the obstetric/gynecology clinic and presented with severe urinary complications. She complained of dysuria, frequency, vaginal irritation, and spraying while voiding. Physical exam was within normal limits; however, genital examination revealed a 3 cm fungating mass corresponding to a large genital wart at the urethral meatus and peri-urethral area. Due to her progressing symptomatology, CO₂ laser ablation therapy was advised.

HPV directly impacts the public health system, affecting 1% of the US population with an estimated 10-20% prevalence rate. Treatment options such as CO₂ laser ablation offers complete removal for most patients with limited side-effects. Accurate follow-up is necessary to monitor proper recovery.

CO₂ laser ablation is considered an effective form of therapy in cases where immediate removal is desired and surgical excision is not recommended. CO₂ laser ablation provides high clearance rates and minimal instances of recurrence, as well as superior aesthetic outcome.